Key result
Abnormal heart rate recovery demonstrated limited short-term reproducibility, with no definition providing more than 55% concordance between two exercise stress tests performed within 18 weeks.
Why the study?
Does heart rate recovery (HRR) after treadmill exercise testing demonstrate short-term test-retest reproducibility in adult patients?
Observational (n=90)
Yes
Does heart rate recovery (HRR) after treadmill exercise testing demonstrate short-term test-retest reproducibility in adult patients?
Effect estimate: 50% concordance
Heart rate recovery after exercise stress testing demonstrates poor short-term test-retest reproducibility, suggesting it may not be a reliable independent prognostic marker for individual patients in routine clinical practice.
HRR's poor short-term reproducibility cautions against individual prognostic use; leaves open its value in research with standardized protocols.
BACKGROUND: Slowed heart rate recovery (HRR) of less than 12 beats per minute in the first minute after an exercise stress test has been suggested as a useful addition to the criteria currently used to assess exercise stress test results. Although HRR has been tested in large populations, the short-term test-retest stability (reproducibility) of abnormal HRR for an individual has not been assessed. METHODS: The study was a retrospective comparison of medical record information using a community-practice-based sample of 90 patients undergoing 2 exercise stress tests separated by 18 weeks or less. Concordance of abnormal HRR results on the first and second stress tests were assessed for individual patients using definitions of abnormal HRR from the medical literature. RESULTS: Individual patient's HRR was markedly variable from the first to second stress test. In this sample, no definition of abnormal HRR provided more than 55% concordance between results from the first and second stress tests. CONCLUSION: These preliminary data suggest that HRR appears to have limited short-term test-retest stability or reproducibility and therefore might not be a reliable addition to current results of exercise stress tests.
No takes yet. Share an insight, caveat, or question.
Barbara P. Yawn (2003) conducted an observational in Equivocal or nondiagnostic exercise stress test results (n=90). Heart rate recovery (HRR) measurement vs. First vs second stress test was evaluated on Concordance of abnormal HRR results between the first and second stress tests (50% concordance). Abnormal heart rate recovery demonstrated limited short-term reproducibility, with no definition providing more than 55% concordance between two exercise stress tests performed within 18 weeks.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: